关节液中多糖含量与关节软骨损伤的关系

目的研究膝关节外伤后,关节液中糖胺多糖含量与关节镜下关节软骨损伤程度的关系,探讨糖胺多糖作为一种生物标记物早期诊断和监测由创伤造成的骨性关节炎病变的可能性。方法1999年5月至2001年9月收集由创伤造成的单侧膝关节外伤病例74例(年龄范围15~70岁,平均年龄39岁),患膝已渡过急性炎症期并无炎症的病人(均为受伤2个月后),可有程度不等的关节功能障碍。于关节镜手术前抽取关节液,采用Alcian blue染色法用酶标仪测定糖胺多糖含量;并在关节镜下,采用Outerbridge分期评定软骨损伤程度。结果关节镜下软骨有轻度损伤的病例较无损伤的病例糖胺多糖含量高(P<0.05);在关节软骨损伤程度较轻时,糖胺多糖含量与软骨损伤程度间存在正相关关系(rs=0.553,0.05>P>0.02)。结论当关节软骨损伤程度较轻时,糖胺多糖可以早期诊断关节软骨损伤,并可用来监测骨性关节炎的病情发展,以及作为评价疗效的一种手段。

The Relationship between the Concentration of Glycosaminoglycan in Synovial Fluid and the Injury-degree of Articular Cartilage

Objective To study the relationship between the concentration of glycosaminoglycan in synovial fluid and the injury-degree of articular cartilage, and discuss the feasibility of the glycosaminoglycan as a marker to diagnose the osteoarthritis(OA) at early stage. Methods 74 patients (age from 15 to 70, the mean age was 39) who had been injured in single knee before 2 months were analyze retrospectively, now the patients have not any inflammations. GAG concentrations were analyzed in joint fluid samples which were taken before arthoendoscopy operation. The injury-degree of articular cartilage were graded and recorded under arthoendoscopy. Results GAG concentrations have relationship with the injury-degree of articular cartilage (r_s=0.553, P<0.05) when the grade scores under 10. Conclusion The detection of GAG concentrations may be used to evaluate the injury-degree of articular cartilage and the treatment effects and also to predict the development of OA.